Cash crisis hits Aids fund

The Global Fund to Fight Aids, Malaria and TB, the largest funder of Aids programmes worldwide, has an estimated shortfall of $3-billion to $5-billion and has begun to scale back dramatically the number of grants it makes.

This emerged at the 5th International Conference on HIV Pathogenesis, Treatment and Prevention in Cape Town this week. Africa is expected to be affected most drastically — Mozambique will receive no money from the fund in the coming year and Tanzania and Swaziland’s domestic Aids programmes are already experiencing major cutbacks.

Aids scientists and activists at the conference raised grave concerns about the potential impact of the global financial crisis on health funding, predicting devastating effects on Aids programmes.

International Aids Society (IAS) president Julio Montaner holds donation governments primarily responsible for under-funding.

“[The IAS is] appalled by the recent G8 meeting,” he said, “where they remained absolutely silent [on Aids funding], and we are one year away from universal access [to treatment] targets in 2010. We will make our G8 leadership accountable … [This silence] is not just pathetic, it’s criminal.”

Professor Jerry Coovadia of the University of KwaZulu-Natal said he was “not surprised” by the shortfall. “As far as I can remember, the struggle for freedom has always been blocked by broken promises from the West.”

But Coovadia also underscored the responsibility of African governments for Aids programmes. “It’s also a problem of our own governments, who are not accountable,” he said.

This week Médécins Sans Frontières announced ARV stock-outs in six African countries — including South Africa, where patients seeking treatment in KwaZulu-Natal are being turned away.

Vuyiseka Dubula of the Treatment Action Campaign said the stock-outs could be blamed entirely on lack of funding. “There is very poor planning and budgeting on antiretroviral roll-out … We don’t have ARV stock-outs just because we don’t have resources — sometimes we do have resources and we’re not using them wisely.”

The financial shortfalls coincide with calls by scientists for increased provision of antiretroviral treatment as a means of preventing further HIV transmission. They say that this could almost eradicate the virus by 2050.

The World Health Organisation’s Reuben Granich presented findings on the “treatment as prevention” model, which calls for universal voluntary testing and placing people on ARVs immediately after a positive result.

Current WHO guidelines recommend that people begin treatment when their CD4 count, a measure of immune response, drops below 350. In South Africa the number is lower, with most public sector patients not receiving drug treatment until their CD4 is well below 200.

Granich’s approach draws on mounting evidence that HIV transmission rates fall dramatically when a person is receiving treatment. Granich said the viral load, or how much HIV is detected in a person’s blood, is “the single greatest risk factor for HIV transmission”.

The ability of ARVs to “lower viral load to undetectable levels” led to lower transmission rates, he said. His model predicted a 95% reduction in new HIV cases in 10 years, with more than seven million lives saved by 2050.

Questions persist about the cost of such a programme, as a heavy initial investment would be required. However, its advocates argue that such an approach could cut costs in the long run, with fewer people developing opportunistic infections, which are expensive to treat, and the global infection rate diminishing greatly.

Montaner said that “in the context of a financial crisis … we need to be very strategic. Investing in ART is a very wise way forward. We know that treatment saves lives and protects families and puts people back to work. There will be no economy if society is crumbling … because they are dying of Aids.”

PW Botha wagged his finger and banned us in 1988 but we stood firm. We built a reputation for fearless journalism, then, and now. Through these last 35 years, the Mail & Guardian has always been on the right side of history.

These days, we are on the trail of the merry band of corporates and politicians robbing South Africa of its own potential.

To help us ensure another 35 future years of fiercely independent journalism, please subscribe.


Soundtrack to a pandemic: Africa’s best coronavirus songs

Drawing on lessons from Ebola, African artists are using music to convey public health messaging. And they are doing it in style

In East Africa, the locusts are coming back for more

In February the devastating locust swarms were the biggest seen in East Africa for 70 years. Now they’re even bigger

Western Cape Judge Mushtak Parker faces second misconduct complaint

The Cape Bar Council says his conduct is ‘unbecoming the holding of judicial office’

‘My biggest fear was getting the virus and dying in...

South African Wuhan evacuee speaks about his nine-week ordeal

Press Releases

The online value of executive education in a Covid-19 world

Executive education courses further develop the skills of leaders in the workplace

Sisa Ntshona urges everyone to stay home, and consider travelling later

Sisa Ntshona has urged everyone to limit their movements in line with government’s request

SAB Zenzele’s special AGM postponed until further notice

An arrangement has been announced for shareholders and retailers to receive a 77.5% cash payout

20th Edition of the National Teaching Awards

Teachers are seldom recognised but they are indispensable to the country's education system

Awards affirm the vital work that teachers do

Government is committed to empowering South Africa’s teachers with skills, knowledge and techniques for a changing world

SAB Zenzele special AGM rescheduled to March 25 2020

New voting arrangements are being made to safeguard the health of shareholders

Dimension Data launches Saturday School in PE

The Gauteng Saturday School has produced a number of success stories